The XIII International AIDS Conference--the world meeting
on AIDS which is held every two years--will meet in Durban,
South Africa July 9-14. AIDS TREATMENT NEWS will be there
but we will not publish live reports. Our next issue, #346,
will be mailed before the conference but may not be
received until the meeting is underway; therefore we are
publishing pre-Durban news in this issue. We will begin our
coverage of the International AIDS Conference in #347.

The Medscape site this year will include reports by six
South African physicians, who will cover issues including
antiretroviral therapy, management of opportunistic
infections, and preventing mother-to-infant transmission in
resource-poor settings.

AEGIS, www.aegis.org, will as always carry wire-
service and other AIDS news reports.

Information specific to women can be found at the
organizing site of the Women's Satellite meeting,
www.womenatdurban.org

And speeches of South African President Thabo Mbeki and
Deputy President Jacob Zuma, as well as press releases from
their office, are always available at
www.gov.za/president/index.html Incidentally, an
excellent 4-part background series on Mbeki, published in a
major South African newspaper just over a year ago, is
available at:
www.suntimes.co.za/1999/05/16/insight/in01.htm
New Oral DNA Vaccine Funded for Trials

The International AIDS Vaccine Initiative (IAVI) will fund
testing of a new kind of preventive vaccine, which has been
developed at the Institute for Human Virology (IHV), started
in 1996 by Robert Gallo, M.D., at the University of Maryland.
IAVI funds promising AIDS vaccines under intellectual-
property agreements which will help make successful ones
available at affordable prices to developing countries.

The new vaccine will be taken orally, and could possibly cost
less than $1 per dose to produce.

(1) There are many advantages to vaccines which work by
delivering DNA which instructs cells to produce the specific
proteins against which immunity is needed. But ordinarily DNA
could not be taken orally because it would not reach the
places it needs to go. The new technology uses a salmonella
bacterium which has been genetically modified so that it does
not cause disease--and also genetically modified so that it
includes selected parts of HIV.

The salmonella bacterium "knows its way around the gut," and
delivers the selected DNA directly to dendritic cells in the
intestinal mucosa, which may be particularly effective for
providing "mucosal immunity" to prevent HIV infection. This
is important for blocking sexual transmission of the virus.

(2) This bacterium has plenty of room to carry added DNA,
allowing great flexibility for modifications. If the first
vaccine does not work, different versions can easily be made
by trying other parts of the virus. And this vaccine can be
customized for the different viral strains which cause
epidemics in different parts of the world.

(3) The six standard children's vaccines cost less than $1 to
produce (for all six), but $15 or more per person to deliver
in developing countries, because of the need for sterile
injection, specially trained health workers, etc. An oral
medication should be much less expensive to deliver.

This vaccine is well along in its development, but clinical
trials are still more than a year away. The first trials will
take place in Baltimore and in Uganda, where the Ministry of
Health is an active participant in this program. One trial
will compare this vaccine head to head against an injected
formulation which uses the same active ingredients but a very
different delivery system--a vaccine also being funded by
IAVI.

"The driving force for this decade-long effort [to create the
new vaccine] has been the development of a simple delivery
system for an HIV vaccine that can be administered without
needles and that can be afforded by developing nations.
Salmonella-DNA has these attributes built in from the start.
We are extremely excited now to be able to evaluate this
strategy in human volunteers," said Dr. George Lewis,
Director of the IHV Division of Vaccine Research.

For more information on the Institute of Human Virology, see
www.ihv.org ; for information on IAVI, see
www.iavi.org
_
AIDS Treatment News
Published twice monthly

Statement of Purpose:AIDS Treatment News reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available.

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